Key Takeaways

• A legitimate ESA letter requires a telehealth or in-person evaluation with a state-licensed mental health professional who establishes a therapeutic relationship and diagnoses a qualifying mental health condition
• ESA letters are federally protected under the Fair Housing Act but are NOT recognized by the Air Carrier Access Act as of 2026, meaning they do not grant air travel privileges
• Qualification requires documented mental or emotional disability that substantially limits one or more major life activities, plus evidence that an emotional support animal provides therapeutic benefit
• Legitimate providers charge $150-$250 for a comprehensive evaluation, while instant letters for $50-$80 are nearly always fraudulent
• Valid ESA letters must include specific therapist credentials, license numbers, contact information, and diagnosis codes—generic templates violate housing law requirements

What Is a Legitimate ESA Letter?

An Emotional Support Animal (ESA) letter is a formal document written by a licensed mental health professional that verifies an individual has a mental or emotional disability and prescribes an emotional support animal as part of their treatment plan. A legitimate ESA letter is the legal documentation required under the Fair Housing Act (FHA) to request reasonable accommodation for an assistance animal in housing that otherwise has pet restrictions or fees.

The letter functions as medical documentation that establishes two critical facts: (1) the tenant has a qualifying disability as defined by federal law, and (2) the prescribed emotional support animal provides necessary therapeutic benefit that alleviates one or more symptoms of that disability. Unlike service animal documentation, ESA letters contain clinical information and require an established therapeutic relationship between the patient and the mental health provider.

As of 2026, ESA letters grant housing rights exclusively. They do not provide public access rights, air travel privileges, or exemptions from local animal control regulations. The Department of Transportation eliminated ESA recognition for air travel in January 2021, a policy that remains in effect. For more information on the distinction between service animals and emotional support animals, the ADA National Network provides comprehensive guidance on federal requirements.

Who Qualifies for an ESA Letter?

An individual qualifies for an ESA letter if they have a diagnosed mental health condition that substantially limits one or more major life activities and a licensed mental health professional determines that an emotional support animal provides therapeutic benefit for that condition. The disability must be documented through clinical evaluation and meet the federal definition established by the Americans with Disabilities Act (ADA) and Fair Housing Act.

Qualifying Mental Health Conditions

The following conditions most commonly qualify individuals for ESA letters, provided they meet severity thresholds:

Anxiety disorders including generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, and post-traumatic stress disorder (PTSD). The condition must cause significant impairment in daily functioning, work performance, or social relationships. Individuals experiencing frequent panic attacks, severe social avoidance, or intrusive trauma symptoms often demonstrate clear functional limitations that an ESA can help manage. According to recent survey data on which mental health conditions benefit most from ESA companionship, anxiety disorders show some of the strongest therapeutic responses to emotional support animals.

Depressive disorders including major depressive disorder, persistent depressive disorder (dysthymia), and seasonal affective disorder. Qualifying depression involves symptoms such as persistent low mood, loss of interest in activities, social isolation, difficulty maintaining daily routines, or suicidal ideation. An emotional support animal can provide companionship that combats isolation and creates structured caregiving routines that improve motivation. NAMI provides detailed information on mental health conditions that may qualify for ESA support.

Obsessive-compulsive and related disorders where compulsive behaviors or intrusive thoughts significantly interfere with daily life. The presence of an emotional support animal can interrupt compulsive cycles, provide grounding during acute anxiety episodes, and offer a focus for attention redirection.

Bipolar and related disorders where mood cycling affects relationship stability, work consistency, or self-care. Emotional support animals provide routine stabilization and can serve as early warning indicators when mood episodes begin.

Attention-deficit/hyperactivity disorder (ADHD) in adults where executive function deficits substantially impair work performance, time management, or daily task completion. The caregiving responsibilities associated with an ESA can create external structure and accountability.

Autism spectrum disorder in adults where social communication challenges, sensory sensitivities, or restricted interests cause significant functional limitations. Emotional support animals can reduce sensory overwhelm, provide non-verbal companionship, and ease social anxiety in community settings.

The Disability Threshold

Not every mental health diagnosis qualifies for ESA accommodation. The condition must "substantially limit" at least one major life activity—a legal standard that means the impairment significantly restricts the ability to perform tasks that average people can perform with little or no difficulty. Major life activities include caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, communicating, working, and thinking. The EEOC provides additional disability-related resources that clarify these standards.

A person with mild, well-managed anxiety who experiences occasional stress does not meet the disability threshold. A person with severe anxiety who experiences debilitating panic attacks multiple times per week, avoids necessary medical appointments due to social anxiety, or cannot maintain employment due to symptom severity does meet the threshold.

The Legitimate ESA Letter Evaluation Process

A legitimate ESA letter requires a real-time consultation with a state-licensed mental health professional who conducts a clinical assessment, reviews mental health history, and determines whether an emotional support animal is an appropriate therapeutic intervention. This process typically takes 30-60 minutes and must occur via HIPAA-compliant telehealth video call or in-person appointment.

Step 1: Initial Clinical Assessment

The licensed therapist or psychiatrist conducts a structured clinical interview that covers:

• Current symptoms and their severity, including frequency of episodes, duration of symptoms, and impact on daily functioning
• Mental health history, including previous diagnoses, past treatment, medication trials, and hospitalization history
• Functional limitations caused by the condition, with specific examples of how symptoms interfere with work, relationships, self-care, or community participation
• Current treatment plan, including therapy, medication, support systems, and coping strategies
• Previous experience with animals, including whether the individual currently has a pet, has had therapeutic benefit from animals in the past, or has specific animal preferences

The provider assesses whether the individual meets diagnostic criteria for a mental health condition using the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), the standard diagnostic framework used by mental health professionals.

Step 2: Disability Determination

The clinician evaluates whether the diagnosed condition rises to the level of a disability under the Fair Housing Act. This requires documentation that the condition substantially limits one or more major life activities. The provider may ask questions such as:

• How many days per month do symptoms prevent you from going to work or completing necessary tasks?
• Do your symptoms cause you to avoid social situations, medical appointments, or essential errands?
• Have you lost employment, relationships, or housing due to your mental health symptoms?
• Do you require medication, therapy, or other interventions to manage daily functioning?

This step separates legitimate evaluations from fraudulent services. Illegitimate providers skip disability determination entirely and issue letters to anyone who pays, regardless of whether they have a qualifying condition.

Step 3: Therapeutic Animal Evaluation

The provider must determine that an emotional support animal specifically provides therapeutic benefit for the individual's diagnosed condition. This is not automatic—not every person with a mental health condition benefits from an ESA, and the clinician must document the clinical reasoning.

The assessment includes:

• How will the animal's presence alleviate specific symptoms? (e.g., "The animal's companionship will reduce social isolation and provide motivation for daily routines" or "The animal will provide grounding during dissociative episodes")
• Does the individual have the capacity to care for an animal, or would caregiving responsibilities create additional stress?
• Are there alternative interventions that might be more appropriate?
• Is the individual currently stable enough to integrate an animal into their treatment plan?

Step 4: Therapeutic Relationship Requirement

Federal housing guidance requires that ESA letters come from providers with whom the tenant has an established therapeutic relationship or who have conducted a comprehensive individualized assessment. As of 2026, HUD guidance specifically warns landlords that letters from providers who have had no meaningful interaction with the tenant beyond issuing the letter are suspect.

Legitimate providers establish this relationship through:

• A live, interactive consultation (not a questionnaire or form)
• Review of previous mental health records when available
• Clinical documentation of the assessment in the individual's medical file
• Availability for follow-up communication with the landlord's legal team if questions arise

Many illegitimate online services violate this requirement by selling letters instantly without any real evaluation, often using automated systems or providers who rubber-stamp approvals without conducting assessments. Research on ESA approval rates by state reveals significant variation in how different regions handle these requirements.

Step 5: Letter Issuance and Documentation

After completing the evaluation, the licensed professional writes the ESA letter on professional letterhead. The provider maintains a clinical record of the evaluation in compliance with state health information privacy laws and federal HIPAA regulations. The individual receives the official letter, typically in both physical and digital formats, which they can then present to their landlord. For detailed information on who can write an ESA letter, understanding provider qualifications is essential.

What Must Be Included in a Valid ESA Letter (2026 Requirements)

A legally compliant ESA letter must contain specific information to satisfy Fair Housing Act verification requirements. Landlords and property managers are trained to identify fraudulent letters, and missing any of these elements can result in rejection of the accommodation request.

Required Elements:

1. Provider's name and professional credentials (e.g., "John Smith, Ph.D., Licensed Clinical Psychologist")
2. Provider's state license type and number (e.g., "California License #PSY12345"). The license must be current and active in the state where the tenant resides or where the provider practices telehealth.
3. Provider's contact information including business address, phone number, and email address. This allows landlord verification.
4. Issue date and statement validity period. Most ESA letters are valid for one year from the date of issue.
5. Statement that the patient is under the provider's care for a mental or emotional disability.
6. Confirmation that the disability substantially limits one or more major life activities, using language that references Fair Housing Act standards without disclosing the specific diagnosis.
7. Statement that the emotional support animal is necessary as a reasonable accommodation to afford the tenant equal opportunity to use and enjoy the dwelling.
8. Description of the therapeutic benefit the animal provides, in general terms that maintain medical privacy.
9. Professional signature of the licensed mental health professional, either handwritten or legally compliant digital signature.

What Should NOT Be Included:

• Specific diagnosis names or diagnostic codes should not appear on the letter itself (though the provider has this information in their clinical records). The FHA does not require disclosure of the specific diagnosis to landlords.
• "Service animal" language. ESAs are not service animals, and conflating the two categories creates legal confusion.
• Exaggerated or non-clinical language such as "this person absolutely needs this animal" or "rejection would be catastrophic." Professional clinical language maintains credibility.
• Claims about public access rights or air travel privileges, which do not exist for ESAs as of 2026.

State-Specific ESA Letter Requirements and Variations

While the Fair Housing Act is federal law that applies uniformly across all 50 states, individual states have added specific regulations governing how ESA letters are obtained, particularly regarding telehealth evaluations and out-of-state providers. Understanding state-specific rules is critical to ensuring your ESA letter will withstand scrutiny. Comprehensive information on emotional support animal laws varies by jurisdiction and requires careful attention.

California ESA Letter Requirements

California has the strictest ESA letter regulations in the United States. Assembly Bill 468 (effective January 1, 2022, and still enforced in 2026) requires that licensed professionals conduct an in-person or live telehealth evaluation at least 30 days before issuing an ESA letter. This law was designed to combat the flood of fraudulent online ESA letters.

California residents cannot legally obtain an ESA letter from:

• Websites that issue instant letters without a live consultation
• Out-of-state providers without California licensure
• Providers they have not had a 30-day therapeutic relationship with

Legitimate California ESA letters must come from providers licensed by the California Board of Psychology, the California Board of Behavioral Sciences, or the Medical Board of California. For residents seeking ESA letters California, understanding these requirements is critical. California ESA laws are among the most comprehensive in the nation and set the standard for legitimate evaluations.

**Florida ESA Letter Requirements*"

Florida law requires that any mental health professional providing telehealth services to Florida residents must hold an active Florida license or register with the Florida Board of Medicine/relevant licensing board. Out-of-state providers cannot issue ESA letters to Florida residents without proper Florida authorization, a rule that became more stringently enforced following 2023 legislation targeting fraudulent online mental health services.

New York ESA Letter Requirements

New York follows federal FHA guidelines without additional state-specific restrictions as of 2026, but the New York State Office of Mental Health has issued consumer warnings about fraudulent ESA letter mills. New York landlords are particularly vigilant about verifying provider licenses through the New York State Education Department's professional license verification system. For those seeking ESA letters New York, understanding New York ESA laws ensures compliance with both federal and state verification standards.

Texas ESA Letter Requirements

Texas allows telehealth ESA evaluations from providers licensed in Texas or licensed in another state through interstate compacts. However, Texas landlords frequently challenge ESA letters from out-of-state providers, and tenants may face additional verification burdens if their provider is not Texas-licensed.

Interstate Licensing and Telehealth Compacts

As of 2026, 29 states participate in the Psychology Interjurisdictional Compact (PSYPACT), which allows licensed psychologists to provide telehealth services across state lines without obtaining multiple licenses. This significantly expands access to legitimate ESA evaluations for residents of participating states.

States participating in PSYPACT include: Alabama, Arizona, Arkansas, Colorado, Delaware, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin.

Social workers and licensed professional counselors have similar interstate compacts (the Social Work Licensure Compact and the Counseling Compact), though participation varies by state.

**Red Flags of Illegitimate ESA Letter Providers**

The proliferation of fraudulent "ESA letter" websites has created a significant problem for tenants seeking legitimate accommodation and landlords attempting to verify requests. As of 2026, housing authorities estimate that 40-60% of ESA letters presented to landlords are fraudulent or non-compliant. Learning to identify illegitimate providers protects you from wasting money on worthless documentation and protects landlords from invalid accommodation requests. Research on the state of ESA ownership in 2026 highlights the challenges posed by fraudulent providers. This guide on best emotional support animal letter websites explains how to spot legitimate services and avoid scams.

Instant Letter Issuance

If a website promises an ESA letter within 24 hours or "same-day approval," it is almost certainly fraudulent. Legitimate clinical evaluations require a live consultation with a licensed professional, review of mental health history, and professional clinical judgment. This process cannot be completed instantly.

Fraudulent providers use one of several schemes:

• Automated systems that generate letters immediately upon payment
• Unlicensed "evaluators" who rubber-stamp every application
• Providers who issue letters without ever speaking to the client
• Pre-signed letter templates with the client's name inserted

No Live Consultation Required

Any service that issues ESA letters based solely on a written questionnaire, online form, or email exchange is selling fraudulent documentation. Federal housing guidance explicitly requires an individualized assessment, which cannot occur without real-time interaction.

Legitimate services require:

• Scheduled video call or phone consultation (typically 30-60 minutes)
• Interactive clinical interview
• Opportunity for the provider to ask follow-up questions
• Real-time assessment of symptoms and functional limitations

Suspiciously Low Prices

Legitimate ESA evaluations from licensed mental health professionals cost $150-$250 as of 2026, reflecting the professional time required for a comprehensive assessment. Services charging $50-$80 for "instant ESA letters" are not providing legitimate clinical evaluations—they're selling fraudulent documents.

The pricing reflects the economics of mental health care: a licensed clinical psychologist, psychiatrist, or licensed clinical social worker charges $100-$200 per clinical hour. A 30-60 minute ESA evaluation, plus documentation time and potential landlord verification calls, justifies the $150-$250 fee range.

Providers Without Verifiable Licenses

Every legitimate ESA letter must come from a mental health professional with an active, verifiable state license. Fraudulent services often list provider names but do not provide license numbers, or they provide fake license numbers that do not appear in state databases.

Before accepting an ESA letter, verify:

• The provider's license number appears in the relevant state licensing board database
• The license is active and in good standing (not expired, suspended, or revoked)
• The license type is appropriate for conducting mental health evaluations (psychologist, psychiatrist, LCSW, LMFT, LPC—not a general physician or nurse practitioner)
• The provider's name and credentials match their license information exactly

Promises of "100% Approval" or "Money-Back Guarantee"

Legitimate mental health professionals cannot guarantee that every client qualifies for an ESA letter because qualification depends on clinical evaluation. Not everyone who wants an ESA has a qualifying disability, and ethical providers turn away individuals who do not meet criteria.

Services promising "100% approval" or "money-back guarantee if not approved" are admitting they issue letters regardless of whether the client qualifies—a clear indication of fraud.

Generic, Template-Based Letters

Fraudulent ESA letters use generic templates with minimal personalization. Legitimate letters contain individualized clinical information that reflects the provider's actual assessment of the specific patient.

Warning signs include:

• Identical phrasing across multiple letters (visible if you compare letters from the same service)
• No reference to the individual's specific condition or symptoms
• Generic statements like "this person has a mental health condition" without any clinical detail
• Absence of the provider's clinical reasoning for why an ESA is therapeutically necessary

Inclusion of ESA "Registration" or "Certification"

There is no official ESA registry, certification, or database recognized by federal housing law. Any service selling ESA registration, ID cards, certificates, or vest/harness packages alongside letters is selling unnecessary products that provide no legal benefit.

Landlords are not required to accept ESA registrations, and legitimate housing authorities do not recognize them. The only legally relevant document is the ESA letter from a licensed mental health professional.

Out-of-State Providers Without Proper Licensure

Mental health professionals must be licensed in the state where they are providing telehealth services, or they must participate in interstate compacts that allow cross-state practice. Services that assign you to any available provider regardless of licensure location may connect you with someone not legally authorized to practice in your state.

Your ESA letter will not be legally valid if:

• The provider is not licensed in your state of residence
• The provider is not licensed in a state participating in relevant interstate compacts
• The provider's license status cannot be verified

How to Use Your ESA Letter with Landlords: Legal Rights and Best Practices

Once you have obtained a legitimate ESA letter from a licensed mental health professional, you have the legal right under the Fair Housing Act to request reasonable accommodation for your emotional support animal in housing that otherwise restricts pets. However, understanding the correct process for submitting your request and knowing your rights protects you from illegal denials while maintaining positive landlord relationships. Justia provides detailed legal guidance on housing laws for service animals and emotional support animals.

Initial Accommodation Request Process

Submit your ESA accommodation request in writing, ideally before signing a lease or before bringing the animal into your residence. While you can submit a request at any time during your tenancy, advance notice demonstrates good faith and allows the landlord time to process the request properly.

Your initial request should:

1. State that you are requesting a reasonable accommodation under the Fair Housing Act due to a disability.
2. Specify that you have a disability-related need for an emotional support animal as verified by a licensed mental health professional.
3. Include your ESA letter from the licensed professional as supporting documentation.
4. Describe the specific animal (species, breed if applicable, approximate weight/size) if you already have the animal, or indicate that you will be obtaining an emotional support animal.

Send the request via certified mail, email with read receipt, or hand-delivery with a signed receipt to create documentation of submission. Keep copies of all correspondence.

Landlord Rights to Verify Documentation

Landlords have the right to verify that your ESA letter comes from a legitimate licensed professional. This is not discrimination—it is a reasonable step to prevent fraud. Landlords may:

• Contact the provider to confirm they issued the letter and conducted an evaluation
• Verify the provider's license status through state licensing databases
• Request clarification about the therapeutic relationship between you and the provider
• Ask whether the provider is familiar with you and your disability-related need

Landlords may NOT:

• Require disclosure of your specific diagnosis
• Demand your complete mental health records
• Ask intrusive questions about the nature of your disability
• Require more documentation than is necessary to verify the disability and need for accommodation

When Landlords Can Deny ESA Requests

Not all ESA accommodation requests must be granted. Landlords can legally deny requests in specific circumstances:

If the animal poses a direct threat to health or safety that cannot be eliminated or reduced through reasonable modifications. This requires evidence of the specific animal's behavior, not breed-based assumptions. A landlord cannot deny an ESA request simply because the animal is a pit bull or other breed considered "aggressive," but they can deny if the specific animal has a documented history of biting, attacking, or aggressive behavior.

If the animal would cause substantial physical damage to the property that cannot be remedied through reasonable accommodation. Again, this must be based on the specific animal's demonstrated behavior, not assumptions about species or breed.

If accommodating the ESA would create an undue financial or administrative burden for the landlord. This exception is narrow and typically applies only to very small landlords or unusual circumstances. Simply not liking animals or having a "no pets" policy does not constitute undue burden.

If the housing is exempt from Fair Housing Act requirements. FHA exemptions include:

• Owner-occupied buildings with four or fewer units
• Single-family homes sold or rented without a real estate agent
• Private clubs that provide lodging to members
• Housing operated by religious organizations

Rights You Have That Landlords Cannot Violate

You cannot be charged pet fees, pet deposits, or pet rent for an emotional support animal. ESAs are not pets under the Fair Housing Act—they are assistance animals related to a disability accommodation. Charging pet fees for an ESA is illegal disability discrimination.

You cannot be restricted to specific units or buildings based on having an ESA, unless there is a legitimate safety reason (e.g., units on higher floors for large animals in buildings without elevators). Landlords cannot segregate tenants with ESAs into "pet-friendly" areas.

You cannot be denied based on breed or weight restrictions that apply to pets. ESAs are exempt from breed bans and weight limits unless the specific animal poses a direct threat or causes substantial damage.

You are responsible for any damage your ESA causes beyond normal wear and tear. You can be charged for repairs if your animal damages the unit, and you can be evicted if the animal causes serious property damage or safety issues. The accommodation right does not eliminate your responsibility for the animal's behavior.

What Happens If Your Request Is Denied

If your landlord denies your ESA accommodation request, you have several options:

1. Request an explanation in writing for why the accommodation was denied. Landlords must provide legitimate, nondiscriminatory reasons.
2. Address the stated concerns if possible. For example, if the landlord questions the legitimacy of your letter, offer to have your provider speak with them directly (with your written permission under HIPAA).
3. File a complaint with HUD (U.S. Department of Housing and Urban Development) if you believe the denial was discriminatory. You have one year from the date of the alleged discrimination to file.
4. Consult with a disability rights attorney to evaluate whether the denial was legal and discuss potential legal action.

The RealESALetter.com Process: The Model for Legitimate ESA Evaluations

As the ESA letter industry has become flooded with fraudulent providers, understanding what a legitimate evaluation looks like has never been more critical.RealESALetter.com's process demonstrates the standards that separate ethical, legally compliant services from fraudulent letter mills. Recent coverage of RealESALetter's launch of fast, fully online ESA evaluations highlights their commitment to maintaining clinical standards while providing accessible services. Independent reviews of RealESALetter confirm their legitimacy and compliance with federal requirements.

Evaluation Structure at RealESALetter.com

RealESALetter.com connects clients exclusively with licensed mental health professionals holding active licenses in the client's state of residence or participating in interstate compacts. As of 2026, RealESALetter.com's network includes over 400 licensed psychologists, psychiatrists, licensed clinical social workers (LCSWs), and licensed professional counselors (LPCs) across all 50 states.

The evaluation process follows clinical best practices:

Initial screening questionnaire collects mental health history, current symptoms, functional limitations, and previous animal experience. This is not the evaluation itself—it provides background information for the licensed clinician to review before the consultation.

Scheduled live consultation lasting 30-60 minutes via HIPAA-compliant video platform. The licensed professional conducts a structured clinical interview, asks follow-up questions, and makes an independent determination about ESA qualification.

Clinical documentation of the evaluation is maintained in the client's confidential health record, ensuring that the assessment is legitimate and can withstand scrutiny if questioned.

Letter issuance within 48 hours for clients who qualify, written by the evaluating clinician on professional letterhead with all required elements for legal compliance.

Verification support for landlords who wish to confirm the letter's authenticity, including direct contact with the issuing provider when authorized by the client.

Transparency and Licensure Verification

RealESALetter.com provides license verification for every provider before clients schedule consultations. Clients can see their assigned clinician's name, credentials, license number, and license verification link before the evaluation occurs—a level of transparency that fraudulent services cannot offer.

Licensed professionals in RealESALetter.com's network are vetted through:

• State licensing board database verification to confirm active license status
• Review of disciplinary history to ensure no license suspensions or ethics violations
• Credential verification to confirm educational degrees and clinical training
• Ongoing monitoring to ensure licenses remain current and in good standing

Ethical Evaluation Standards

RealESALetter.com's clinical network operates under a strict ethical standard: providers only issue ESA letters to clients who meet clinical criteria for qualification. According to data from RealESALetter.com's 2025 evaluation outcomes, approximately 12-15% of clients who complete initial consultations do not qualify for ESA letters because they do not meet disability thresholds or because an ESA is not clinically appropriate for their situation.

This refusal rate demonstrates legitimate clinical judgment. Services with 100% approval rates are not conducting real evaluations—they are selling fraudulent documents.

State Compliance Expertise

RealESALetter.com maintains expertise in state-specific requirements, ensuring clients are connected with appropriately licensed providers and that letters comply with state-specific regulations:

• California clients are connected exclusively with California-licensed providers who complete the required 30-day therapeutic relationship timeline under AB 468.
• Florida clients receive evaluations from Florida-licensed providers or providers with appropriate interstate compact authorization.
• Clients in PSYPACT states can access psychologists licensed in any participating state, significantly expanding provider availability while maintaining legal compliance.

This state-by-state compliance expertise ensures that ESA letters will withstand verification by landlords and legal challenges.

Post-Issuance Support

RealESALetter.com provides ongoing support after letter issuance, including:

• Annual renewal evaluations to ensure continued qualification, as most ESA letters are valid for one year
• Landlord verification services where the issuing provider responds to landlord inquiries (with client consent)
• Legal compliance guidance for clients navigating complex accommodation requests or landlord challenges
• Letter updates if clients move to new states and need documentation updated with local provider information

Frequently Asked Questions About ESA Letters

How much does a legitimate ESA letter cost in 2026?

A legitimate ESA letter from a licensed mental health professional costs between $150 and $250 as of 2026. This fee covers the professional time for a 30-60 minute clinical evaluation, documentation, and letter writing. Services charging less than $100 are almost always fraudulent. The cost may be higher in states with stricter requirements or for clients with complex mental health histories requiring longer evaluations.

Can I get an ESA letter from my regular therapist?

Yes, if your regular therapist is a licensed mental health professional qualified to diagnose mental health conditions, they can write your ESA letter. In fact, ESA letters from established therapists who have ongoing treatment relationships with clients are considered the gold standard for legitimacy. Psychologists, psychiatrists, licensed clinical social workers (LCSWs), licensed professional counselors (LPCs), and licensed marriage and family therapists (LMFTs) can all write ESA letters within their scope of practice. However, primary care physicians, nurse practitioners, and general practitioners typically cannot write ESA letters unless they have specialized mental health training and licensure.

How long does an ESA letter stay valid?

Most ESA letters are valid for one year from the date of issue. After one year, you need a renewal evaluation to confirm that you still have a qualifying disability and that the emotional support animal continues to provide therapeutic benefit. Some landlords may accept letters that are slightly older than one year, but annual renewal is the standard recommendation. RealESALetter.com and other legitimate providers offer streamlined renewal evaluations for existing clients, typically involving a brief check-in consultation to confirm continued need.

What's the difference between an ESA and a service animal?

Service animals are individually trained to perform specific tasks for people with disabilities and have public access rights under the ADA, while emotional support animals provide therapeutic benefit through companionship and presence and have housing rights under the FHA but no public access rights. Service animals (limited to dogs and miniature horses under federal law) must be trained to perform disability-related tasks such as guiding blind individuals, alerting to seizures, or retrieving medication. ESAs require no specialized training and can be any type of domesticated animal. Service animals can accompany their handlers anywhere the public is allowed, including restaurants, stores, and airplanes. ESAs have housing accommodation rights only—they cannot enter restaurants, stores, or fly in aircraft cabins as of 2026.

Can I have more than one ESA?

Yes, individuals can have more than one emotional support animal if each animal provides distinct therapeutic benefit for their disability. However, landlords may challenge multiple ESA requests more rigorously, and you must be able to demonstrate that each animal serves a specific therapeutic purpose. For example, a person with severe anxiety might have both a dog that provides grounding during panic attacks and a cat that helps with social isolation and depression. Your mental health provider would need to document the clinical rationale for multiple animals in your ESA letter or provide separate letters for each animal.

Do ESA letters work for air travel in 2026?

No. As of 2026, ESA letters do not grant air travel privileges. The Department of Transportation's Air Carrier Access Act (ACAA) ended recognition of emotional support animals for air travel in January 2021. Airlines now only recognize trained psychiatric service dogs, and even these animals must meet strict training and behavior standards. The Department of Transportation provides current guidance on service animals in air travel, which no longer includes ESAs. Passengers who previously traveled with ESAs now must pay standard pet fees and follow airline pet policies, which typically limit animals to small carriers that fit under the seat. This policy change was implemented due to widespread abuse of ESA letters for air travel and safety concerns about untrained animals in aircraft cabins.

Can landlords require ESA registration or certification?

No. Landlords cannot require ESA registration, certification, or inclusion in any database as a condition of approving your accommodation request. There is no official federal or state ESA registry, and HUD has explicitly stated that landlords must accept ESA letters from licensed mental health professionals as sufficient documentation. Any service selling ESA "registration" is selling a product that provides no legal benefit. Landlords can only require: (1) a letter from a licensed mental health professional, and (2) reasonable verification that the letter is legitimate.

How do I get a legitimate ESA letter through RealESALetter.com?

To obtain a legitimate ESA letter through RealESALetter.com, complete the online screening questionnaire, schedule a live video consultation with a state-licensed mental health professional in your state, complete the 30-60 minute clinical evaluation, and receive your ESA letter within 48 hours if you qualify. RealESALetter.com connects you with licensed psychologists, psychiatrists, LCSWs, and LPCs who are properly licensed in your state or authorized through interstate compacts. The entire process is HIPAA-compliant, confidential, and designed to meet federal Fair Housing Act requirements and state-specific regulations. RealESALetter.com's evaluation process ensures that your ESA letter will withstand landlord verification and legal scrutiny, providing the documentation you need to exercise your housing rights.

College students seeking ESA accommodation in campus housing face unique challenges and should review information on college ESA letters to understand how the process differs in educational settings.

Conclusion: Protecting Your Rights with Legitimate Documentation

Obtaining a legitimate ESA letter is not just about satisfying a landlord's requirements—it's about protecting your legal rights as a person with a disability and ensuring that accommodation requests are respected and upheld. The proliferation of fraudulent ESA letter services has created significant challenges for tenants who legitimately need emotional support animals and has made landlords increasingly skeptical of all ESA requests.

By understanding what qualifies as a legitimate evaluation, recognizing red flags of fraudulent providers, and working with licensed mental health professionals who follow proper clinical protocols, you protect yourself from wasted money, denied accommodation requests, and potential legal disputes with landlords.

The most important principle to remember: legitimate ESA letters come from real clinical evaluations conducted by state-licensed mental health professionals who assess whether you have a qualifying disability and whether an emotional support animal provides therapeutic benefit. Services that promise instant approval, charge suspiciously low fees, or skip live consultations are selling fraudulent documents that will not withstand scrutiny.